Individual provider Active NPI

Jessica Altman, FNP

  • Family Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1245569722
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32725 Issued in TN
Practice address
1334 Fergie CT
Clarksville, TN 37042-1565
Phone
(931) 237-6461
NPI assigned
Dec 14, 2009
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 32725 TN Primary
Registered Nurse 163W00000X 145461 TN

Addresses

Primary practice location

1334 Fergie CT
Clarksville, TN 37042-1565

Mailing address

1334 Fergie CT
Clarksville, TN 37042-1565
Phone (931) 237-6461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423002536 TN Practitioner - Nurse Practitioner 0042681405 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
East Tennessee State University Quillen College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SHC Medical Partners of Tennessee, LLCGroup PAC ID 1951487826, 21 clinicians
Abode Care Partners LTC VB LLCGroup PAC ID 8325316516, 81 clinicians

Practice addresses (Care Compare)

198 Old Farmers Rd
Clarksville, TN 37043-4032
Phone (931) 358-2900

919 Medical Park Dr
Mountain City, TN 37683-1042
Phone (423) 727-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
145461TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Abode Care Partners Al VB, LLC CurrentSince Jun 21, 2024 Accepting new patients
Abode Care Partners Al VB, LLC CurrentSince Jun 21, 2024 Accepting new patients
SHC Medical Partners of Tennessee, LLC CurrentSince Jan 23, 2023 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince May 11, 2024 Accepting new patients
Abode Care Partners LTC VB, LLC CurrentSince May 11, 2024 Accepting new patients

Locations

12201 Bluegrass Pkwy
Louisville, KY 40299
Phone (502) 568-7364

805 N Whittington Pkwy
Ste 400
Louisville, KY 40222
Phone (502) 272-3438

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

198 Old Farmers Rd
Clarksville, TN 37043
Phone (931) 358-2900

919 Medical Park Dr
Mountain City, TN 37683
Phone (423) 727-7800

415 Cole Dr
Pigeon Forge, TN 37863
Phone (865) 428-5454

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1245569722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 FERGIE CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370421565",
            "telephone_number": "931-237-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 FERGIE CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370421565",
            "telephone_number": "931-237-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32725",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "145461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.